Healthcare Provider Details

I. General information

NPI: 1790828846
Provider Name (Legal Business Name): ELIZABETH ANN WINNER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 MADISON RD
CINCINNATI OH
45227-1491
US

IV. Provider business mailing address

5050 MADISON RD
CINCINNATI OH
45227-1491
US

V. Phone/Fax

Practice location:
  • Phone: 513-272-2800
  • Fax: 513-893-3264
Mailing address:
  • Phone: 513-272-2800
  • Fax: 513-893-3264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADC.954176
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.0003167-S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: